About Szulecki, editor

Editor, American Journal of Nursing

High Opioid Overdose Numbers Spur State, City Initiatives

State 2015 overdose death rates compared with national rate. (CDC image)

As we report in an October news article, recent studies have shed light on the growing scale of the opioid crisis in the United States. Among the latest statistics:

  • 33,000 Americans died in 2015 from an opioid overdose, a high percentage from the use of synthetic opioids such as illegally manufactured fentanyl.
  • The diagnosis of “opioid use disorder” climbed 493% from 2010 to 2016 in Blue Cross Blue Shield claims.
  • Around 4.31% of Americans ages 12 or older use prescription pain relievers for nonmedical uses.

Increasing Naloxone availability.

The findings underscore the urgent need to take steps to combat the crisis—a need that has prompted states and cities to attack the issue using various methods. Baltimore’s health commissioner, for example, issued a standing order for naloxone to be available at all of the city’s pharmacies. Brown University and the Rhode Island School of Design collaborated to create NaloxBoxes—emergency naloxone boxes installed at city social service centers that enable any bystander to administer a rescue dose.

Speeding access to addiction treatment.

And, to minimize delays in patients’ receipt of medication-assisted opioid addiction treatments like methadone, New York State has reached agreements with two insurance companies to end their requirements for prior authorization for such treatments. […]

2017-10-23T08:50:26+00:00 October 23rd, 2017|Nursing, Public health|1 Comment

AJN in October: Nursing Student Errors, Septic Shock Resuscitation, the Ethics of Workarounds, More

The October issue of AJN is now live. Here are some articles we’d like to bring to your attention.

CE: Original Research: Exploring How Nursing Schools Handle Student Errors and Near Misses

The authors investigate nursing school policies and practices for reporting and tracking student errors and near misses. The first part of a two-part series.

CE: Assessing Patients During Septic Shock Resuscitation

How to integrate capillary refill time and skin mottling score into the perfusion reassessment after initial fluid resuscitation—as recommended by revisions to the Surviving Sepsis Campaign six-hour bundle.

Obesity and Sexual Dysfunction: Making the Connection

Obesity affects patients’ general health, but does it affect their sexuality? A review of the evidence on obesity and sexual functioning, plus nursing considerations for addressing weight-loss strategies with patients.

Workarounds Are Routinely Used By Nurses—But Are They Ethical?

How nurses can be creative problem solvers without resorting to workarounds that may be ethical in intent yet potentially harmful in their consequences.

[…]

2017-09-29T08:30:14+00:00 September 29th, 2017|Nursing|0 Comments

How Long Should Routine Health Screening Continue in Older Adults?

Photo by Johner Images / Alamy Stock Photo

Communicating to older patients that routine screening tests are no longer recommended can prove difficult. Recent research, however, offers guidance on how nurses and other clinicians should approach such conversations.

As we report in a September news article, a study focused on cancer screening found that older adults unlikely to benefit from certain tests were receptive to recommendations to stop screening, with a caveat: they preferred that life expectancy not be a part of the conversation.

The study’s accompanying editorial notes that broaching the topic of life expectancy can turn a discussion about maintaining health into an unexpected discussion about the end of life, which “may be a shock in the primary care setting at a routine visit.” The authors of the study recommend changing the language used in these conversations—for example, saying “This test would not help you live longer” instead of referring to “life expectancy.” […]

2017-09-06T09:21:09+00:00 September 6th, 2017|Nursing, patient engagement|1 Comment

AJN September Issue: Family Caregivers and Alzheimer’s, Older Adults and Driving, C. Diff. Prevention, More

The September issue of AJN is now live. Here are some articles we’d like to bring to your attention.

CE: Original Research: The Experience of Transitioning to a Caregiving Role for a Family Member with Alzheimer’s Disease or Related Dementia

This qualitative study explores the experiences of people who transitioned to the role of caregiver for a family member with Alzheimer’s disease or a related dementia. Vivid interview excerpts illuminate the inner struggles caregivers may experience as they navigate a radically changed existence as well as the strategies that have helped them find their way.

CE: Can Your Older Patients Drive Safely?

Many older Americans depend on their cars for independence and connection to the outside world. What are the driving risks associated with advanced age? What behaviors and situations put older drivers at greatest risk, and what are the key indicators of an older patient’s ability to drive safely? Nurses are in a position to raise patients’ awareness of these risks and inform them about transportation alternatives.

Six Things You Can Do Today to Prevent Hospital-Onset C. Difficile Tomorrow

What changes can you make in your practice to prevent transmission of this common bacterial infection?

Lessons Learned from Litigation: Legal and Ethical […]

2017-08-25T09:03:28+00:00 August 25th, 2017|Nursing|0 Comments

U.S. Life Expectancy Varies Depending on County of Birth

image via Wikimedia Commons / Wapcaplet

A new study that compared life expectancy by county from 1980 to 2014 has shed light on geographic disparities, which have been increasing over the past 35 years. One of the study’s major findings, as we report in an August news article, is that the difference in life expectancy between the U.S. county with the highest life expectancy and the one with the lowest is 20.1 years.

The counties with the lowest life expectancies include several in North Dakota and South Dakota (in particular, those with Native American communities), and counties along the lower half of the Mississippi River and in Kentucky and West Virginia. Meanwhile, counties in central Colorado have the highest life expectancies.

While national life expectancy increased from 73.8 years to 79.1 years during the study period, the researchers noted regional inequalities in this improvement: some counties in the South experienced little to no improvement in life expectancy, while others on both coasts and in Colorado and Alaska saw large increases. They also found that geographic differences in life expectancy decreased for children and adolescents but increased for adults—especially for those ages 65 to 85 years. […]

2017-08-11T09:04:39+00:00 August 11th, 2017|Nursing|0 Comments